| Purpose:Lung cancer is one of the world’s most common cancers, the incidence and mortality rates tended to increase year by year, accounting for the first of all malignant tumors,and the non-small cell lung cancer NSCLC accounts for 80% of the cancers.Because of the insidious onset and rapid development of lung cancer, local or distant metastasis has occurred to more than two-thirds of the patients at the first time of diagnosis, that is to say, when the initial treatment begins, it’s already advanced, then chemotherapy, radiation, molecular targeted therapy has become the main way.The platinum-based joint 3rd generation chemotherapy is the first-line standard treatment of lung cancer. With the development of the times, there have been new drugs into the market. It has been confirmed by a large number of clinical programs that ALIMTA, EGFR-TKIs and other drugs can be used for effectiveness and safety of advanced non-small cell lung cancer.In choosing a good treatment options for patients, the accurate evaluation is essential,the response evaluation criteria in solid tumors,RECIST 1.0 and RECIST 1.1 in 2009 are the most popular ways. But EGFR-TKIs are inconsistent with cytotoxic drugs from the mechanism of action, mode of action and targets, then finding a more effective method for the evaluation of molecular is particularly important.This study is aimed compare results between patients treated by PET / CT evaluation of drug efficacy and application of CT in the evaluation of drug efficacy to get a better evaluation criteria in order to guide further treatment.Methods:The data are collected from 21 cases of patients confirmed by histopathology confirmed since July 2013 to January 2015,occupancy of Respiratory Medicine, in the Fourth Hospital of Hebei Medical University. As required, accurate records of all study patients’ gender, age, smoking status, pathological type, clinical stage, EGFR gene mutation, treatment options, efficacy evaluation, etc., for each patient before and after treatment enhanced chest CT and PET/CT in the evaluation of drug efficacy.The disease control rate and objective response rate were compared using chi-square test used for analysis of efficacy evaluation between the two groups RECIST 1.1 and EORTC evaluation results comparing two standard mining Wilconxon signed rank test(Wilconxon Signed- Rank Test), all statistics P<0.05 was considered statistically significant.Results:1 Clinical characteristics of the objectAmong all the patients enrolled, there are eight male patients, accounting for 38% and 13 female patients, accounting for 62%.The age distribution is in the range of 38-79 years old, the average age is 57.7 ± 2.3 years old. 10 cases are at the age <60 years old, accounting for 47.6%, 11 patients ≥60 years old, accounting for 52.4%. A total of 18 cases of patients are with adenocarcinoma, accounting for 85.7%, three cases of glandular squamous cell carcinoma(14.3%). Smokers are three cases(14.3%), 18 patients with non-smokers, accounting for 85.7%.2 Study regimenAmong the 21 patients, 14 patients were treated with EGFR-TKIs molecular targeted therapy, 66.7%, 10 patients of which were accepted for the first-line treatment of EGFR-TKIs, 4 patients treated by second-line treatment of EGFR-TKIs accepted. There are seven cases accepting ALIMTA plus cisplatin regimen, accounting for 33.3%.3 EvaluationIn 21 patients, the application of the evaluation criteria for CR RECIST1.1 to 0 cases were evaluated for the PR person for the three cases, the evaluation of SD were 14 cases of PD were evaluated for the four cases, the objective response rate was 14.3% disease control rate was 81.0%.EORTC criteria for evaluating applications for CMR as one cases were evaluated for the PMR for 13 cases were evaluated for SMD’s for two cases, were evaluated for five cases of PMD, objective response rate was 67.7%, the disease control rate was 76.2%. Evaluation results of the two methods of application of the Wilcoxon rank sum test results Z is-2.840, P value of 0.005, the difference was statistically significant between the two.There are 14 patients who take EGFR-TKIs, among which no one takes RECIST 1.1 evaluation, 3 PR, 7 SD, 4 PD.Objective response rate was 21%, disease control rate was 71%. EORTC criteria for evaluating applications for CMR were 0 case, PMR were 10 cases, SMD were to 0 cases, PMD were 4 cases.Objective response rate was 71%, disease control rate was 71%, the two criteria to evaluate the results of the Wilcoxon rank sum test results Z =-2.646, P=0.008, significant differences exist between the two, with statistical significance.4 The influence of △SUV on Prognostic FactorsIn 21 patients, the EORTC criteria for evaluating applications for PMR+ CMR total of 14 cases of patients, 14 patients twice PET / CT △SUV after a median of 3.95, then we intercept 4 as the cutoff point, △SUV≥4 total patients seven cases, the median PFS had no result, △SUV <4 patients with a total of seven cases, the median PFS for seven months, the application between the two groups Kaplan-Meier survival curve analysis methods, make survival Log- rank method significant test calculated, P = 0.24, besides, there is no statistically significant difference.Conclusions:1 This study show differences between the EORTC standard RECIST criteria.2 In this study, EORTC criteria can provide a more accurate assessment of the treatment of NSCLC, so they guide the next treatment for NSCLC patients.3 This study intercepting 4 for SUV change value point. No cross two survival curve, △SUV for PFS may predict the trend of PFS. |
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